Endometriosis in the cecum diagnosed via forward-viewing endoscopic ultrasound-guided tissue acquisition with a 19G fine-needle biopsy needle: a case report.
Kensei Kawasaki, Kotaro Takeshita, Shuta Otachi et al.
✦ AI-curated · Sources linked
Case in brief
A 30-year-old woman was referred after colonoscopy identified a protruding cecal lesion. Contrast-enhanced CT showed a 37-mm enhancing mass and an adjacent lesion considered a possible enlarged lymph node, raising suspicion for a gastrointestinal stromal tumor. A forward-viewing echoendoscope reached the cecum, allowing tissue acquisition from both lesions. Histology and immunohistochemistry demonstrated endometrial glands and stroma, positive for estrogen receptor, progesterone receptor, and CD10, establishing cecal endometriosis. The diagnosis supported initial non-surgical management without immediate surgery.
What made this case unusual
A forward-viewing echoendoscope enabled EUS-guided tissue acquisition from a right-sided colonic lesion, where access with an oblique-viewing echoendoscope can be difficult; the suspected tumor was diagnosed as endometriosis.
Diagnostic / clinical pearl
For a cecal subepithelial lesion with imaging features suggestive of a gastrointestinal stromal tumor, tissue diagnosis can reveal endometriosis and inform management.